Isolated cardiac metastasis after comprehensive treatment with hepatocellular carcinoma: a case report and literature review.
Yu Yao, Ying-Jie Tang, Xiang Nong et al.
✦ AI-curated · Sources linked
Case in brief
A 61-year-old male with BCLC-B stage hepatocellular carcinoma (HCC) underwent liver resection and subsequent treatments, including immunotherapy and radiofrequency ablation. Three years post-surgery, imaging revealed an isolated mass in the right ventricle, diagnosed as cardiac metastasis of HCC. Despite treatment with lenvatinib and sintilimab, the patient died two weeks later from suspected cardiac rupture.
What made this case unusual
This case highlights the rare occurrence of isolated cardiac metastasis of HCC in the right ventricle, without involvement of the right atrium or inferior vena cava.
Diagnostic / clinical pearl
Clinicians should maintain a high index of suspicion for cardiac metastasis in HCC patients with multiple recurrences and rising alpha-fetoprotein levels, even after ruling out intrahepatic recurrence.
Why it matters
This case underscores the need for vigilant follow-up in HCC patients, particularly those with extensive treatment histories, to detect potential extrahepatic metastases early.